{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:01Z","timestamp":1740126841331,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to compare cesarean delivery (CD) rates and maternal\/neonatal outcomes before and after the 2014 ACOG\/SMFM Obstetric Care Consensus for Safe Prevention of Primary CD.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective study compared unscheduled CD rates and outcomes of singleton, cephalic, term pregnancies at a tertiary-care teaching maternity hospital. Births 5 years before (March 2009\u2013February 2014) and after (June 2014\u2013May 2019) release of the consensus were included. Chi-square and t-test were used to compare outcomes and logistic regression to adjust for confounders.<\/jats:p><jats:p>\n            Results\u2003In this study, 44,001 pregnancies were included, 20,887 before and 23,114 after the consensus. Unscheduled CD rates increased after the consensus (12.9 vs. 14.3%, p\u2009&lt;\u20090.001); however, there was no difference after adjustment (adjusted odds ratio [aOR], 0.97; 95% confidence interval [CI], 0.91\u20131.03). Vaginal birth after cesarean (VBAC) deliveries increased among multiparas (4.8 vs. 7.2%, p\u2009&lt;\u20090.001), which remained significant after adjustment (aOR, 1.51; 95% CI, 1.37\u20131.66). Postpartum hemorrhage, blood transfusion, and chorioamnionitis were modestly increased, while third-degree perineal lacerations decreased. Uterine rupture and neonatal outcomes were unchanged after adjustment.<\/jats:p><jats:p>\n            Conclusion\u2003At our tertiary-care maternity hospital, the Safe Prevention of Primary CD Care Consensus was not associated with a change in unscheduled CD, though VBAC deliveries increased. We did not demonstrate improved neonatal outcomes and showed increased maternal morbidity that warrants further study.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1760387","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T03:35:46Z","timestamp":1674012946000},"page":"e1084-e1089","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Associations between the Safe Prevention of Primary Cesarean Delivery Care Consensus and Maternal\/Neonatal Outcomes"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-0985","authenticated-orcid":false,"given":"Pamela","family":"Estrada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Tipton","sequence":"additional","affiliation":[{"name":"School of Natural Sciences and Mathematics, Data Science, Analytics, and Visualization, Chaminade University of Honolulu, Honolulu, Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rylan","family":"Chong","sequence":"additional","affiliation":[{"name":"School of Natural Sciences and Mathematics, Data Science, Analytics, and Visualization, Chaminade University of Honolulu, Honolulu, Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dena","family":"Towner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Yamasato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Women's Health, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"volume-title":"Births: Final Data for 2018","year":"2019","author":"J A Martin","key":"ref1"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1503\/cmaj.060870","article-title":"Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term","volume":"176","author":"S Liu","year":"2007","journal-title":"CMAJ"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1097\/01.AOG.0000219750.79480.84","article-title":"Maternal morbidity associated with multiple repeat cesarean deliveries","volume":"107","author":"R M Silver","year":"2006","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref4","first-page":"1","article-title":"Births: final data for 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Epidemiol"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1503\/cmaj.130925","article-title":"Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis","volume":"186","author":"E Mishanina","year":"2014","journal-title":"CMAJ"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/1471-2393-13-168","article-title":"Racial and ethnic differences in primary, unscheduled cesarean deliveries among low-risk primiparous women at an academic medical center: a retrospective cohort study","volume":"13","author":"J K Edmonds","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/AOG.0000000000001488","article-title":"Reduction in the cesarean delivery rate after obstetric care consensus guideline implementation","volume":"128","author":"J G Wilson-Leedy","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref14","first-page":"128","article-title":"Racial-ethnic disparities in postpartum hemorrhage in Native Hawaiians, Pacific Islanders, and Asians","volume":"76","author":"S A Harvey","year":"2017","journal-title":"Hawaii J Med Public Health"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1186\/1756-0500-6-395","article-title":"Gestational diabetes and macrosomia by race\/ethnicity in Hawaii","volume":"6","author":"P J Tsai","year":"2013","journal-title":"BMC Res Notes"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1186\/1471-2393-14-298","article-title":"Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawai'i: an observational study from five years of statewide data","volume":"14","author":"T Sentell","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"author":"Centers for Disease Control and 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01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1760387","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published":{"date-parts":[[2023,1,17]]}}}